title: Fetal tyhmus size as a predictor of histological chorioamnionitis in preterm premature rupture of membranes.
abstract: OBJECTIVE
  To predict histological chorioamnionitis (CA) in the cases of preterm premature rupture of membranes by using fetal thymus transverse and anteroposterior diameters and areal measurements.
  
  
  METHODS
  Fifty healthy and 50 patients diagnosed with preterm premature rupture of membranes (PPROM) between 24 and 37 weeks of gestation were included in the study. Fetal thymus measurements were done and repeated on a weekly basis until delivery, Furthermore white blood cell, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were measured every other day until delivery, too. Following delivery, all patients' placentas were sent to pathology.
  
  
  RESULTS
  Histological CA was detected in 48% of the PPROM patients. There were no patients in either group with clinical CA. Thymus transverse diameter had 91% sensitivity, 81% specificity, 82% PPV, and 91% NPV in predicting histological CA in PPROM patients. No linear relationship was found between thymus anteroposterior diameter measurements and gestational age. Thymus area measurements have sensitivity of 75%, specificity of 81%, PPV of 78%, NPV of78% in determining CA in patients with PPROM.
  
  
  CONCLUSIONS
  Both thymus transverse diameter and area measurement are more significant than sedimentation and CRP values in predicting histological CA. Fetal thymus measurements can be used in early diagnosis of infections among high risk patients.
authors.affiliation: Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Womens Health Teaching Hospital , Ankara , Turkey.
authors.forename: Sezin Ertürk
authors.initials: SE
authors.lastname: Aksakal
authors.forename: Omer
authors.initials: O
authors.lastname: Kandemir
authors.forename: Sibel
authors.initials: S
authors.lastname: Altınbas
authors.forename: Sertac
authors.initials: S
authors.lastname: Esin
authors.forename: Kamil Hakan
authors.initials: KH
authors.lastname: Muftuoglu
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002821:Chorioamnionitis / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D047109:Fetal Development; D005322:Premature Rupture of Fetal Membranes / Q000175:diagnosis* / Q000473:pathology; D005865:Gestational Age; D006801:Humans; D009929:Organ Size; D011247:Pregnancy; D011379:Prognosis; D012680:Sensitivity and Specificity; D013950:Thymus Gland / Q000196:embryology / Q000254:growth & development* / Q000473:pathology; D016216:Ultrasonography, Prenatal / Q000379:methods; D055815:Young Adult
keywords: Chorioamnionitis; PPROM; fetal sonography; fetal thymus size